Key result
Home-based primary care linked to ~21% higher odds of HTN control per 90 days.
Why the study?
Home-based primary care models supported by trained health workers and digital platforms may improve non-communicable disease management where healthcare access is limited, yet real-world evidence on their performance is scarce.
Does a subscription-based, home-delivered primary care program improve blood pressure, random blood sugar, and disease control over time in patients with non-communicable diseases in rural India?
Cohort (n=1,668)
Does a subscription-based, home-delivered primary care program improve blood pressure, random blood sugar, and disease control over time in patients with non-communicable diseases in rural India?
Engagement in a digitally enabled, home-based primary care program in rural India was associated with modest longitudinal reductions in blood pressure and increased odds of hypertension and diabetes control, though controlled studies are needed.
May inform scalable rural hypertension models; leaves open confirmation of benefits in randomized trials.
Purpose: Limited access to healthcare can worsen the burden of non-communicable diseases (NCDs). Home-based primary care models, supported by trained health workers enabled with digital platforms, offer a potential strategy to improve NCD prevention and management. Yet, evidence on how such models perform in real-world settings is limited. Methods: We conducted a retrospective analysis of routinely collected data from September 2022 to March 2025 on participants in NEEM, a subscription-based, home-delivered primary care program for managing NCDs in rural Maharashtra, India. Participants received regular home visits for screening, monitoring, medication delivery, and telemedicine follow-up. Among participants with >1 visit, >30 days of follow-up, and at least two complete observations, we used generalized estimating equations to estimate within-person changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and random blood sugar (RBS), overall and by control status at screening, and changes in the population-average odds of hypertension (HTN) and diabetes (DM) control. Results: The primary analytic sample comprised 1,668 participants (12,769 observations; median follow-up 252.5 days). SBP changed by −1.19 mmHg (95% CI: −1.38, −1.01), DBP by −0.75 mmHg (−0.86, −0.64), and RBS by −0.77 mg/dL (−1.40, −0.14) per 90 days. The odds of HTN control increased by 21% (adjusted odds ratio [aOR]: 1.21 [95% CI: 1.17, 1.25]) and of DM control by 6% (aOR: 1.06 [1.04, 1.08]) per 90 days. Conclusions: Among NEEM-engaged participants, blood pressure improved, with weaker evidence for blood sugar. Comparative evaluations are needed to establish whether such models improve control relative to traditional facility-based care.
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Gupta et al. (2026) conducted a cohort in Non-communicable diseases (hypertension and diabetes) (n=1,668). NEEM subscription-based, home-delivered primary care program (regular home visits for screening, monitoring, medication delivery, and telemedicine follow-up) was evaluated on Within-person changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and random blood sugar (RBS), and population-average odds of hypertension (HTN) and diabetes (DM) control per 90 days (aOR 1.21, 95% CI 1.17-1.25). Home-based primary care (NEEM) lowered SBP by 1.19 mmHg (95% CI -1.38 to -1.01) and increased odds of HTN control by 21% (aOR 1.21; 95% CI 1.17-1.25) per 90 days.
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